Medical Providers

Referral Forms and Information for Medical ProvidersIf you are a medical provider and you would like to refer your patient to the Fit Kids clinical program, please make sure:

1. Your patient is currently under 18 years old

2. Your patient is over the 85th percentile for body mass index

3. You have a completed Fit Kids Referral Form marked with any co-morbid conditions and fax to our office. Fax numbers: Flagstaff: 928-214-3591 Verde Valley: 928-634-1879

4. You order blood lab work for your patient that includes:

Fasting Lipid Panel

Hemoglobin A1-C

Fasting Insulin Level

TSH

T4

ALT

Vitamin D 25 hydroxy levels

This will help us identify medical improvements in patient’s health.

We will continue to update you about your patient’s progress in the Fit Kids of Arizona program via letter. We also will follow up occasionally with your office to obtain any patient specific biometric changes as they visit you for regular check-ups.

Also, we like to hear from our referring physicians, so please let us know if you have any feedback or input for our program.